Common Questions About Secure Blue

 

What is Secure Blue?

 

Secure Blue is a Medicare Advantage Preferred Provider Organization (PPO) plan that offers you quality healthcare coverage with the freedom to choose providers from in or out of network. Secure Blue provides financial protection against the unexpected with a low out-of-pocket maximum for healthcare costs.

 

Once you meet your in or out-of-network maximums, the only additional healthcare costs will be your low monthly premiums.

 

What is a Medicare Preferred Provider Organization (PPO)?

 

A PPO is a Medicare Advantage Plan offered by an insurance company that signs a contract with Medicare. Medicare pays a set amount to the insurer to cover plan member health care needs.

 

Does the plan cover more benefits than Medicare Parts A and B?

 

Yes, Secure Blue offers additional benefits beyond Original Medicare including Preventive Care and Wellness Programs, Care Management Services and Vision Care.

 

Secure Blue provides you with peace of mind, knowing you are protected against unexpected hospital costs with low out of pocket cost limits. You pay only $1,500 for in-network or $4,500 for out of network providers and services.

 

Do I file my own claims?

 

No, as a Secure Blue member, you have virtually no paperwork. You simply present your Secure Blue member card and the provider will submit your claim(s) directly to Blue Cross of Idaho for payment.

 

Do I have to get services from specific providers?

 

No, with Secure Blue you can go to any physician, specialist or hospital in or out of network. However, if you receive services from an out of network provider, your costs will be higher.

 

Will I need to get prior authorization?

 

We encourage you to obtain prior authorization for non-plan providers  This helps to ensure that the services are medically necessary and keeps you from incurring any unexpected costs. 

 

Prior authorization is needed for some in-network services including inpatient hospital care, inpatient mental health care, skilled nursing facilities, home health care, physical, occupational and speech therapy and durable medical equipment (for items over $300).

 

For questions about Medicare, visit the Medicare Web site at www.medicare.gov

 

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